Retinal small vessel narrowing in women with gestational diabetes, pregnancy-associated hypertension, or small-for-gestational age babies
BackgroundGestational diabetes, pregnancy-associated hypertension and small-for-gestational age babies are all associated with impaired placental vascularisation. This study compared the effects of these conditions the systemic small vessel calibre that was examined in the retina.MethodsThis was a c...
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1265555/full |
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| author | Joseph Phillipos Thao Vi Luong Deborah Chang Suresh Varadarajan Paul Howat Lauren Hodgson Deb Colville Deb Colville Judy Savige |
| author_facet | Joseph Phillipos Thao Vi Luong Deborah Chang Suresh Varadarajan Paul Howat Lauren Hodgson Deb Colville Deb Colville Judy Savige |
| author_sort | Joseph Phillipos |
| collection | DOAJ |
| description | BackgroundGestational diabetes, pregnancy-associated hypertension and small-for-gestational age babies are all associated with impaired placental vascularisation. This study compared the effects of these conditions the systemic small vessel calibre that was examined in the retina.MethodsThis was a cross-sectional observational study of consecutive pregnant women recruited from an antenatal clinic. Participants underwent a Glucose Tolerance Test, BP measurements, and were examined for small-for-gestational age babies as per national guidelines. They also underwent retinal photography with a non-mydriatic camera, and vessel calibres were measured with a validated semi-quantitative system at a retinal grading centre. Some participants also underwent testing of retinal vascular responsiveness to a flickering light.ResultsWomen with gestational diabetes (n = 68) had a higher mean arterial pressure (85 ± 9 mm Hg) than normal pregnant women (n = 27, 80 ± 8 mmHg, p = 0.01). They also had smaller mean retinal arteriole (147.5 ± 13.6 μm and 159.7 ± 6.7 μm respectively, p < 0.01) and venular calibre (221.0 ± 13.4 μm and 232.8 ± 20.1 μm respectively, p < 0.01) than normal. However their babies’ mean birth weights were not different from normal (3,311 ± 558 g and 3,401 ± 600 g respectively, p = 0.48). They also demonstrated a trend to reduced retinal arteriolar dilatation (3.5 ± 1.3%, n = 23) in response to vasodilatory stimuli (4.4 ± 1.8%) (n = 11) (p = 0.08) consistent with endothelial dysfunction. Women with pregnancy-associated hypertension (n = 35) had a higher mean arterial pressure (101 ± 12 mm Hg, p < 0.01), a smaller mean retinal arteriolar calibre (139.9 ± 10.6 μm, p < 0.0001), and a lower baby mean birth weight than for normal pregnancies (3,095 ± 443 g, p = 0.02). Likewise, women with small-for-gestational age babies (n = 31) had a higher mean arterial pressure (89 ± 19 mm Hg, p = 0.03), a smaller mean retinal arteriolar calibre (141.6 ± 12.8 μm, p < 0.01) and a lower baby mean birth weight than for normal pregnancies (2,468 ± 324 g, p < 0.0001).ConclusionMean retinal arterial calibre was reduced in women with gestational diabetes, pregnancy-associated hypertension or small-for-gestational age babies. The reduction in calibre was greatest in pregnancy-associated hypertension and small-for-gestational age babies. Systemic arteriole narrowing may contribute to the pathogenesis of placental vascular dysfunction in these conditions. |
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| language | English |
| last_indexed | 2024-03-11T18:10:08Z |
| publishDate | 2023-10-01 |
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| spelling | doaj.art-61370d5768c84b6d8647c2f536854fb02023-10-16T15:23:33ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-10-011010.3389/fmed.2023.12655551265555Retinal small vessel narrowing in women with gestational diabetes, pregnancy-associated hypertension, or small-for-gestational age babiesJoseph Phillipos0Thao Vi Luong1Deborah Chang2Suresh Varadarajan3Paul Howat4Lauren Hodgson5Deb Colville6Deb Colville7Judy Savige8The University of Melbourne (Northern Health and Melbourne Health), Parkville, VIC, AustraliaThe University of Melbourne (Northern Health and Melbourne Health), Parkville, VIC, AustraliaThe University of Melbourne (Northern Health and Melbourne Health), Parkville, VIC, AustraliaEndocrine Unit, Northern Health, Epping, VIC, AustraliaDepartment of Obstetrics and Gynaecology, Northern Health, Epping, VIC, AustraliaUniversity of Melbourne, Royal Victorian Eye and Ear Hospital East Melbourne, East Melbourne, VIC, AustraliaThe University of Melbourne (Northern Health and Melbourne Health), Parkville, VIC, AustraliaUniversity of Melbourne, Royal Victorian Eye and Ear Hospital East Melbourne, East Melbourne, VIC, AustraliaThe University of Melbourne (Northern Health and Melbourne Health), Parkville, VIC, AustraliaBackgroundGestational diabetes, pregnancy-associated hypertension and small-for-gestational age babies are all associated with impaired placental vascularisation. This study compared the effects of these conditions the systemic small vessel calibre that was examined in the retina.MethodsThis was a cross-sectional observational study of consecutive pregnant women recruited from an antenatal clinic. Participants underwent a Glucose Tolerance Test, BP measurements, and were examined for small-for-gestational age babies as per national guidelines. They also underwent retinal photography with a non-mydriatic camera, and vessel calibres were measured with a validated semi-quantitative system at a retinal grading centre. Some participants also underwent testing of retinal vascular responsiveness to a flickering light.ResultsWomen with gestational diabetes (n = 68) had a higher mean arterial pressure (85 ± 9 mm Hg) than normal pregnant women (n = 27, 80 ± 8 mmHg, p = 0.01). They also had smaller mean retinal arteriole (147.5 ± 13.6 μm and 159.7 ± 6.7 μm respectively, p < 0.01) and venular calibre (221.0 ± 13.4 μm and 232.8 ± 20.1 μm respectively, p < 0.01) than normal. However their babies’ mean birth weights were not different from normal (3,311 ± 558 g and 3,401 ± 600 g respectively, p = 0.48). They also demonstrated a trend to reduced retinal arteriolar dilatation (3.5 ± 1.3%, n = 23) in response to vasodilatory stimuli (4.4 ± 1.8%) (n = 11) (p = 0.08) consistent with endothelial dysfunction. Women with pregnancy-associated hypertension (n = 35) had a higher mean arterial pressure (101 ± 12 mm Hg, p < 0.01), a smaller mean retinal arteriolar calibre (139.9 ± 10.6 μm, p < 0.0001), and a lower baby mean birth weight than for normal pregnancies (3,095 ± 443 g, p = 0.02). Likewise, women with small-for-gestational age babies (n = 31) had a higher mean arterial pressure (89 ± 19 mm Hg, p = 0.03), a smaller mean retinal arteriolar calibre (141.6 ± 12.8 μm, p < 0.01) and a lower baby mean birth weight than for normal pregnancies (2,468 ± 324 g, p < 0.0001).ConclusionMean retinal arterial calibre was reduced in women with gestational diabetes, pregnancy-associated hypertension or small-for-gestational age babies. The reduction in calibre was greatest in pregnancy-associated hypertension and small-for-gestational age babies. Systemic arteriole narrowing may contribute to the pathogenesis of placental vascular dysfunction in these conditions.https://www.frontiersin.org/articles/10.3389/fmed.2023.1265555/fullgestational diabetespregnancy-associated hypertensionsmall-for-gestational age babiesmicrovascularplacenta vesselspregnancy |
| spellingShingle | Joseph Phillipos Thao Vi Luong Deborah Chang Suresh Varadarajan Paul Howat Lauren Hodgson Deb Colville Deb Colville Judy Savige Retinal small vessel narrowing in women with gestational diabetes, pregnancy-associated hypertension, or small-for-gestational age babies Frontiers in Medicine gestational diabetes pregnancy-associated hypertension small-for-gestational age babies microvascular placenta vessels pregnancy |
| title | Retinal small vessel narrowing in women with gestational diabetes, pregnancy-associated hypertension, or small-for-gestational age babies |
| title_full | Retinal small vessel narrowing in women with gestational diabetes, pregnancy-associated hypertension, or small-for-gestational age babies |
| title_fullStr | Retinal small vessel narrowing in women with gestational diabetes, pregnancy-associated hypertension, or small-for-gestational age babies |
| title_full_unstemmed | Retinal small vessel narrowing in women with gestational diabetes, pregnancy-associated hypertension, or small-for-gestational age babies |
| title_short | Retinal small vessel narrowing in women with gestational diabetes, pregnancy-associated hypertension, or small-for-gestational age babies |
| title_sort | retinal small vessel narrowing in women with gestational diabetes pregnancy associated hypertension or small for gestational age babies |
| topic | gestational diabetes pregnancy-associated hypertension small-for-gestational age babies microvascular placenta vessels pregnancy |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1265555/full |
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